Borrower First Name:

Borrower Last Name:

Borrower Contact Phone: () -

Borrower Email Address:

Select FICO Score: Impaired: Below 650 Compromised: 650 to 680 Fair: 680 to 710 Average: 710 to 730 Good: 730 to 750 Very Good: 750 to 770 Excellent: 770 to 790 Superb: Above 790 (highest if married)

Enter Annual Gross Earnings (before taxes): (combined earnings if married)

Select Required LoanTerm: 12 months 24 months 36 months 48 months 60 months